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Just an Ulcer or could it be Oral Cancer?

Should your ulcer worry you?

Written by: Dr. Nijam

September 10, 2020

Mouth ulcers are very common and can be due to a variety of reasons. Trauma from accidentally biting your tongue or lip is a common cause of ulcer. Drinking a hot cup of coffee too quickly can also result in an ulcer. Other causes include certain medications, stress, viral, bacterial or fungal infections and certain foods. The mouth is often the part of the body that gives us clues about the health of the entire body. As such, mouth ulcers can also be due to nutritional deficiencies such as deficiencies in Vitamin B12, folate and iron. Skin disorders (Lichen Planus), gastrointestinal disorder (Crohn’s disease) and immunological disorders (Bechet’s syndrome) can manifest as mouth ulcers. Among these many different causes, a persistent mouth ulcer can also be due to oral cancer which if not detected early enough can lead to significant spread to other areas of the head and neck requiring invasive treatment or result even in death.

From 2008 to 2012, about 500 people were diagnosed with oral cancer in Singapore, making up an average of 100 cases a year. In Singapore and other parts of the world, only half of the oral cancer patients managed to survive for more than five years after diagnosis and treatment. It gets more difficult to treat cancer if it is diagnosed later, and this is why it’s extremely important to look out for the warning signs and go for health checks regularly to detect the early signs.

What is Oral Cancer?

Oral cancer is cancer that develops in any of the parts that make up the mouth and throat such as lips, gums, tongue, the inside lining of the cheeks and the roof or floor of the mouth. The possible signs and symptoms of oral cancer are swelling, lumps or bumps, red or white patches in the mouth, a persistent ulcer that does not seem to heal after 3 weeks, a change in the way the teeth fit or dentures fit, difficulty chewing, and persistent sores, among others.

What-is-Oral-Cancer

Oral cancer or mouth cancer can be particularly dangerous as the early symptoms are usually painless or not easily noticeable. Hence, patients would either self-medicate or completely ignore the symptoms until the cancer has metastasized (spread) to another location—mostly the lymph nodes of the neck. Prognosis at this stage of discovery is significantly worse than when it is caught in the localized area in the mouth. This is because the cancer has not only spread, at the later stages, the primary tumour also has had time to invade deep into local structures, which may make it even harder to treat.

Oral cancers are also more frequent among men than women, especially the middle-aged and elderlies. However, in recent years, an increasing number of women are being diagnosed with oral cancer. This year, the American Cancer Society estimated around 10,750 deaths surrounding the oral cavity and oropharyngeal cancers in the United States. Nevertheless, there are ways to treat and control oral cancer, mainly with early detection. If cancer has spread to deeper areas of the face and jaw considerably, extensive surgery will be required to remove the cancerous growth and this often leaves the patient with some disfigurement of the face.

There are plenty of factors that lead to mouth cancer but the biggest risk factor is the consumption of alcohol and tobacco use—chewing tobacco or smoking cigarettes, cigars and pipes.

Canker Sore VS Oral Cancer

Canker-Sore-VS-Oral-Cancer

What differentiates between the two?

  • Canker Sore – Typically small, bubble-like ulcers that can be found inside the mouth, lip, cheeks or tongue. They can be painful at times but they are not contagious nor cancerous. Canker sore looks like an ulcer but the middle part may appear white, grey or yellow while the edges are red. You can self-medicate canker sore by applying medications, eating soft food or gargling with salt water, and it will go away in a matter of one to two weeks’ time.
  • Oral Cancer – In the early stages of oral cancer, it may look like an open canker sore (which explains the confusion) or it could also take the form of a discoloured lump on the edge of the lip. However, unlike canker sore, oral cancer does not heal or go away. It will stay in a concentrated spot before spreading more aggressively. So before it spreads, it is vital for you to get a quick check-up with your dentist for early detection.

How to reduce the risk of Oral Cancer

1. Do not smoke

Do-not-smoke

1. Do not smoke

If you are an avid smoker, refrain from using tobacco be it chewed or smoked. Tobacco exposes the cells in your mouth to dangerous chemicals that can lead to cancer. If you don’t use tobacco, great! And don’t start!

2. Drink alcohol in moderation

Drink-alcohol-in-moderation

2. Drink alcohol in moderation

High alcohol intake can irritate the cells in your mouth, making them vulnerable to cancer. You can drink, but try to do so in moderation. Healthy women can drink up to one glass (approx. 350ml) per day. As for adult men, one drink per day is recommended for those aged 65 and above, and two drinks (approx. 700ml) per day for those below the age of 65.

3. Avoid excessive sun

Avoid-excessive-sun

 3. Avoid excessive sun

Excessive exposure to the sun can cause lip cancer. Limit your sun exposure or use UVA/B-blocking sun-protective lotions on your skin and lips when going out.

4. See a dentist

See-a-dentist

4. See a dentist

Sometimes, dangerous lumps or spots in your mouth can appear very tiny and difficult to detect on your own. Therefore, it is advisable to seek professional help from your dentist. With regular dental checkups, we can detect any unusual signs early and suggest the next best step to you. So be sure to not skip your biennial dental appointment!

Are you due for a dental health check? Come book an appointment with us!

Have an interesting topic you would like us to cover? Just let us know!

References:

1. Facts about moderate drinking. (2019, December 30). Retrieved September 09, 2020, from https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

2. Fighting Oral Cancer with Drool //. (n.d.). Retrieved September 09, 2020, from https://www.ndcs.com.sg/giving/fighting-oral-cancer-with-drool

3. Friedman, M. (2019, October 10). Oral Cancer: Symptoms, Causes, Treatments, and More. Retrieved September 09, 2020, from https://www.webmd.com/oralhealth/guide/oral-cancer

4. Key Statistics for Oral Cavity and Oropharyngeal Cancers. (n.d.). Retrieved September 09, 2020, from https://www.cancer.org/cancer/oral-cavity-and-oropharyngealcancer/about/key-statistics.html

5. Mouth cancer. (2019, January 03). Retrieved September 09, 2020, from https://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/syc20350997

6. Oral Cancer (Mouth Cancer). (n.d.). Retrieved September 09, 2020, from https://www.healthhub.sg/a-z/diseases-and-conditions/170/oral_disease_and_oral_cancer_nuh

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